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학습 자료 둘러보기 →| Assessment Finding | Associated Complication | Priority Rationale |
|---|---|---|
| Tracheal deviation away from the injured side with severe respiratory distress | Tension Pneumothorax | Highest priority. This indicates a mediastinal shift causing kinking of the vena cava, which leads to obstructive shock and imminent cardiovascular collapse. Immediate needle decompression is required. The Essential Trauma Care guidelines emphasize that the organization of trauma care systems must be prepared to manage such life-threatening injuries promptly to lower mortality [1]. |
| Subcutaneous emphysema around the neck and chest | Pneumothorax or airway injury | High priority, but not the highest. Subcutaneous emphysema indicates air leaking into the soft tissues, which confirms a breach in the respiratory system. While it signals a significant injury, it does not inherently confirm the hemodynamic compromise of a tension physiology. |
| Diminished breath sounds with dullness to percussion | Hemothorax | High priority. Dullness to percussion suggests fluid (blood) in the pleural space rather than air (which would cause hyperresonance). A massive hemothorax can cause shock from blood loss, but it does not cause the immediate mediastinal shift and cardiovascular compression seen in a tension pneumothorax. |
| Severe chest pain (8/10) that worsens with inspiration | Rib fractures, pulmonary contusion | Lower priority. Pain is an expected finding and must be managed to prevent splinting and atelectasis, but it is not a direct sign of an immediately life-threatening complication. The physiological threat from uncontrolled pain is less acute than the obstructive shock from a tension pneumothorax. |
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